No RN Provided on 25% of Night Shifts and Assessments Performed by Unqualified Personnel

The Georgia Healthcare Facility Regulation Division cited Lighthouse Care Center of Augusta for violations related to staffing, hospital governance, discharge records, and emergency restraint procedures. Surveyors found that contrary to the rule, a registered nurse had not been present on more than 25% of night shifts within a three month period. Hospital policy was violated when physicians practicing at the facility were found to be missing documentation for reappointment to the medical staff. The facility administrator confirmed this, adding that “ongoing quality review of care provided by the physicians had not been completed.” When the administrator was questioned about physicians failing to sign patient discharge summaries, it was “confirmed that physicians had not been required to develop, complete, and/or sign discharge summaries.” The facility was also cited for failing to follow proper procedure for emergency safety interventions. For example, it was found that the hospital failed to have a nurse complete patient assessments within one hour of initiating the emergency restraint procedure. Interviews with the Director of Nursing revealed that some evaluations were signed as though they were completed by a registered nurse as required, even though actual assessments were completed by other staff.